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氢气治疗新生儿坏死小肠结肠炎

已有 3466 次阅读 2013-8-16 22:18 |个人分类:氢气生理盐水|系统分类:论文交流

新生儿坏死小肠结肠炎是以腹胀、呕吐和便血为主要临床表现,肠壁囊样积气为X线特征的一种严重疾病。90%发生于早产儿,同时伴有肠壁积气和门静脉积气者死亡率高达86%好发部位为回肠远端及近端升结肠,重者可累及全胃肠道,十二指肠较少受累。主要改变为肠腔充气,黏膜呈斑片状或大片坏死,肠壁不同程度积气、出血及坏死,严重时肠壁全层坏死和穿孔。该病缺乏特异性药物治疗手段,临床治疗方法包括禁食、胃肠减压、抗感染、支持疗法和其他治疗,有凝血机制障碍时可输新鲜冰冻血浆,出现休克时给予抗休克治疗。明显腹膜炎时可考虑手术、肠穿孔时应立即手术治疗。

由于该疾病存在系统炎症表现,氢气被证明可以治疗类似疾病,主要通过抗氧化、抗炎症等方式发挥作用,上海交通大学盛庆丰等最近研究发现氢气生理盐水注射后,新生儿坏死小肠结肠炎后动物结肠组织学、炎症因子、氧化损伤指标等均有明显改善。研究结果提示,氢气对该疾病具有潜在的应用价值。该文章最近在线发表在《小儿外科杂志》。

Purpose

The aim of thisstudy was to test the hypothesis that hydrogen-rich saline (HRS) might haveprotective effects on the development of necrotizing enterocolitis (NEC) in aneonatal rat model.

Methods

NEC was induced inmale newborn Sprague–Dawley rats by formula feeding, exposure to asphyxia andcold stress. Sixty-four rat pups were divided randomly into four groups:C + NS (n = 11), C + H2(n = 11), NEC + NS (n = 20), andNEC + H2 (n = 22). Rats in the former two groupswere mother-fed. Pups received intra-peritoneal injection of HRS(10 ml/kg, 10 min before asphyxia stress twice a day) or the samedose of normal saline. Rats were monitored until 96 h after birth. Bodyweight, histological NEC score, survival time, malondialdehyde, antioxidantcapacity, inflammatory mediators, and mucosal integrity were assessed.

Results

HRS treatmentmaintained the body weight, reduced the incidence of NEC from 85% (17/20) to54.5% (12/22), increased the survival rate from 25% (5/20) to 68.2% (15/22),and attenuated the severity of NEC. In addition, HRS inhibited the mRNAexpression of pro-inflammatory mediators (inducible nitric oxide synthase,tumor necrosis factor-α, and interleukin-6), down-regulated lipid peroxidation,enhanced total antioxidant capacity, and prevented the increase of diamineoxidase in serum. However, no significant influence of HRS on theinterleukin-10 mRNA expression was observed.

Conclusions

HRS showedbeneficial effects on neonatal rats with NEC via decreasing oxidative stress,increasing antioxidant capacity, suppressing inflammation, and preservingmucosal integrity.

 




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